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Hysteroscopy Comment: Dr. Alfonso Arias

For many years, hysteroscopy was only used for early diagnosis of endometrial adenocarcinoma, considering hysteroscopic surgery an absolute contraindication. Today, that vision has changed, and hysteroscopic resection is gaining popularity as an acceptable modality in the conservative treatment of focal endometrial adenocarcinoma in patients of reproductive age. It is similar to the evolution of endoscopic treatment of other types of gynecological cancer, as up no more tan one decade ago, endoscopic procedures were contraindicated in nearly all types of cancer. Such behavior is very different today.

In my opinion, this has happened due to 2 main reasons: First, the introduction of the Bettocchi hysteroscopic set that allowed the routine practice of in office hysteroscopy and second, the development of bipolar resectoscopes that allowed the young endoscopist, with less experience, perform hysteroscopic surgery making such procedures cleaner, faster and safer.

These two reasons have led to a higher number of gynecologists interested in learning and practicing these techniques, which has motivated the experts to do more teaching resulting in a rapidly increased of hysteroscopists worldwide.

But hysteroscopy needs to become more popular. Office hysteroscopy should be readily available in every gynecologic practice. Group practices should designate one or two member of the group to become “experts” in office hysteroscopy. Those of us who already have some decades in practice are always available to younger physicians for formal training.